摘要
目的研究亚低温治疗重型颅脑损伤病人脑组织氧分压(PbtO2)和脑温的变化规律及其临床意义。方法将重型颅脑损伤病人116例分为亚低温组和常温对照组各58例,对病人监测PbtO2、脑温,平均86h。结果24hPbtO2均值(13.7 ±4.94)mmHg,较正常值(16～40mmHg)低;亚低温组比对照组PbtO2恢复到均值的时间缩短(10±4.15)h(P <0.05);亚低温组存活率(60.4%)高于对照组(46.6%);复温后PbtO2随脑温升高而增加。手术组脑温与肛温的差距低于正常者占66.7%,非手术组脑温与肛温的差距高于正常者占52.9%,两组有显著性差异。结论亚低温治疗能提高严重脑伤病人的生存率。PbtO2、脑温直接监测技术安全可靠,对于判定病情和指导治疗有重要意义。
Objective To study the changes of partial pressure of brain tissue oxygen (PbtO2 ) and brain temperature (Tb) of patients with severe head injury, and effect of mild hypothermia therapy on PbtO2 and Tb. Methods 116 patients with severe head injury were divided into two groups (mild hypothermia group 58 patients and control group 58 patients), according to the odd and even numbers of hospitalization. PbtO2 and Tb were monitored for 86 hours in average. Follow-up time was 6 months and the outcome of the patients was evaluated according to Glasgow outcome Scale (GOS). Results The mean 24-hour PbtO2 value in all patients was (13.7 ± 4.94) mmHg, lower than the normal value (16～40 mmHg). The time of PbtO2 recovering to the normal value in mild hypothermia group was (10 ± 4.15) h shorter than that in the control group (P < 0.05).The survival rate of mild hypothermia group was 60.43%, higher than that of the control group (46.55%). When the temperature recovered, the PbtO2 increased with the rising of the brain temperature. Conclusion Mild hypothermia can improve the survival rate of severe head injury. The techniques of monitoring PbtO2 and Tb are safe and reliable, which are very important in judging disease condition and giving instructions to clinical therapy.
出处
《中国微侵袭神经外科杂志》
CAS
2004年第3期115-117,共3页
Chinese Journal of Minimally Invasive Neurosurgery
基金
绍兴地区科技局科研基金资助项目(绍科评字55号)
关键词
重型颅脑伤
脑温
脑组织氧分压
亚低温疗法
病情监测
severe head injury
brain tissue oxygen (PbtO2)
brain temperature (Tb)
mild hypothermia
